AIM: To conduct a comparative study of effectiveness of silicone hydrogel contact lens and hydrogel contact lens, which are used in patients after laser-assisted subepithelial keratomileusis(LASEK).·METHODS: Sixt...AIM: To conduct a comparative study of effectiveness of silicone hydrogel contact lens and hydrogel contact lens, which are used in patients after laser-assisted subepithelial keratomileusis(LASEK).·METHODS: Sixty-three patients(121 eyes) with a spherical equivalent ≤-5.0 D were chosen after undergoing LASEK in 2012 at Guangdong General Hospital. They were randomly divided into 2 groups. The silicone hydrogel group included 32 cases(61 eyes) that wore silicone hydrogel contact lenses for 4-6d after the operation, while the hydrogel group included 31 cases(60 eyes) who wore hydrogel contact lenses for 4-6d after the operation. Patients’ self-reported postoperative symptoms(including pain, photophobia, tears, and foreign body sensation) were evaluated. The healing time of the corneal epithelium, the visual acuity of patients without contact lens after epithelial healing, and the incidence of delayed corneal epithelial shedding were also assessed. The follow-up time was 1mo.·RESULTS: Postoperative symptoms were milder in the silicone hydrogel group than in the hydrogel group.There were significant differences in pain, foreign body sensation, and photophobia between the 2 groups(P <0.05),although there was no significant difference in postoperative tearing(P >0.05). The healing time of the corneal epithelium in the silicone hydrogel lens group was markedly shorter than that in the hydrogel group(4.07±0.25 vs 4.33±0.82 d, t =2.43, P =0.02). Visual acuity without contact lenses after healing of the corneal epithelium was better in the silicone hydrogel group compared with the hydrogel group(χ~2=7.76, P =0.02).There was no significant difference in the occurrence ofdelayed corneal epithelial shedding between the 2 groups(P >0.05).· CONCLUSION: Patients with LASEK using silicon hydrogel contact lenses had less discomfort and shorter corneal epithelial healing time compared with those using hydrogel contact lenses, suggesting that silicon hydrogel contact lenses may be considered to be a better choice of bandage contact lens after LASEK.展开更多
AIM: To evaluate the safety of therapeutic bandage contact lens for post-cataract surgery patients and to illustrate its efficacy on post-operative comfort and tear-film stability. METHODS: A total of 40 participants ...AIM: To evaluate the safety of therapeutic bandage contact lens for post-cataract surgery patients and to illustrate its efficacy on post-operative comfort and tear-film stability. METHODS: A total of 40 participants were recruited and randomly divided into two groups. Group one was instructed to wear bandage contact lenses for a week and use antibiotic eye drops for a month since the first day after surgery. Group two received sub-conjunctival injection of tobramycin and was asked to wear eye pads on the first day after surgery and then were instructed to use antibiotic eye drops as the first group did. Ocular surface disease index(OSDI) questionnaire, slit-lamp microscope examination of tear break-up time(TBUT), corneal fluorescein score(CFS), tear meniscus height(TMH) together with anterior segment optical coherence tomography(AS-OCT) and corneal topography were evaluated preoperatively and postoperatively. RESULTS: The subjective feeling(P=0.004), TBUT(P<0.001) and TMH(P=0.02) post-surgery had improved in patients who used bandage contact lenses compared with those who did not at 1wk post-surgery. Until three month postoperatively, the comfort degree(P=0.004) and TMH(P=0.01) of group two were still worse than group one. Moreover, TBUT(P<0.001) and CFS(P=0.004) of the group with eye pads got worse than the results before, whereas the group with bandage contact lenses recovered to normal. None of these patients had infections or other complications. CONCLUSION: Wearing therapeutic bandage contact lens after cataract surgery, compared with traditional eye-pads, is a safe method to improve tear-film stability and reduce post-operative discomfort without hindering corneal incision recovery.展开更多
AIM: To evaluate the corneal cell morphology of new keratoconus patients wearing two different types of rigid gas-permeable(RGP) contact lenses for 1y.METHODS: Thirty nine eyes of 39 new keratoconus patients were sele...AIM: To evaluate the corneal cell morphology of new keratoconus patients wearing two different types of rigid gas-permeable(RGP) contact lenses for 1y.METHODS: Thirty nine eyes of 39 new keratoconus patients were selected and randomly fitted with two types of RGP contact lenses.Group 1 had 21 eyes with regular rigid gas-permeable(RRGP) contact lens and rest 18 eyes were in group 2 with specially designed rigid gas-permeable(SRGP) contact lens.Corneal cell morphology was evaluated using a slit scanning confocal microscope at no-lens wear and after 1y of contact lens wearing.RESULTS: After 1y of contact lens wearing in group 1,the mean anterior and posterior stromal keratocyte density were significantly less(P=0.006 and P=0.001,respectively) compared to no-lens wear.The mean cell area of anterior and posterior stromal keratocyte were also significantly different(P=0.005 and P=0.001) from no-lens wear.The anterior and posterior stromal haze increased by 18.74% and 23.81%,respectively after 1y of contact lens wearing.Whereas in group 2,statistically significant changes were observed only in cell density & area of anterior stroma(P=0.001 and P=0.001,respectively) after 1y.While,level of anterior and posterior stromal haze increased by 16.67% and 11.11% after 1y of contact lens wearing.Polymegathism and pleomorphism also increased after 1y of contact lens wearing in both the contact lens groups.CONCLUSION: Confocal microscopy observation shows the significant alterations in corneal cell morphology of keratoconic corneas wearing contact lenses especially in group 1.The type of contact lens must be carefully selected to minimize changes in corneal cell morphology.展开更多
AIM: To determine the impact of rigid gas permeable(RGP) and silicone-hydrogel keratoconus lenses on the quality of life(Qo L) in keratoconus(KCN) patients using the self-reported results from the Contact Lens Impact ...AIM: To determine the impact of rigid gas permeable(RGP) and silicone-hydrogel keratoconus lenses on the quality of life(Qo L) in keratoconus(KCN) patients using the self-reported results from the Contact Lens Impact on Quality of Life(CLIQ) Questionnaire.·METHODS: From January 2013 to April 2013, 27 consecutive KCN patients who wore RGP contact lenses(conflexair100 UV KE Zeiss-Whlk) or soft silicone-hydrogel contact lenses(SHCLs) for KCN(Kera Soft ICBausch&Lomb or Hydrocone Toris K-Swiss lens)completed the CLIQ questionnaire.·RESULTS: The mean age of 27 patients was 29.6±8.0y.Fifteen patients were RGP user. The groups were comparable with respect to the mean patient age, sex,and mean K values(P =0.1, P =0.8 and P =0.1, respectively).The mean CLIQperson measure was 42.8 ±5.5 in RGP group and 39.6 ±5.5 in SHCLs for KCN group(P =0.06).CLIQperson measure was positively correlated with steep K value(r =0.301, P =0.04). When eyes were stratified by visual acuity with contact lenses, the mean CLIQperson measure was 42. 01 ± 5. 6 in eyes with a visual acuity of20/20-20/25(n =44) and 38.4 ±5.26 in eyes with a visual acuity of 20/32 or less(n =10; P =0.097).·CONCLUSION: RGP lenses and SHCLs for KCN have similar impact on Qo L.展开更多
AIM: To determine the effect of p H, osmolality, and buffering system on the oxygen permeability(Dk) of soft contact lenses.·METHODS: Two hydrogel lenses(nelfilcon A and etafilcon A) and 2 silicone hydrogel lense...AIM: To determine the effect of p H, osmolality, and buffering system on the oxygen permeability(Dk) of soft contact lenses.·METHODS: Two hydrogel lenses(nelfilcon A and etafilcon A) and 2 silicone hydrogel lenses(lotrafilcon A and balafilcon A) were used in the study. These lenses were incubated in phosphate-buffered saline(PBS) and borate-buffered saline(BBS) solutions adjusted by 0.8p H increments to a p H in the range of 5.8-9.0 or in hypotonic(280 m Osmol/kg), isotonic(310 m Osmol/kg)and hypertonic(380 m Osmol/kg) PBS solutions.Polarographic method was used for measuring the Dk and lenses were stacked as 4 layers to correct the boundary effect.·RESULTS: Dk values of all contact lenses measured in BBS solutions were more stable than those in PBS solutions. Especially the etafilcon A lens showed a relative big change compared with other types of contact lenses at the same conditions. When the osmolality of PBS solution increased from hypotonic to hypertonic, Dk of all contact lenses decreased. Variations in Dk existed depending on lens materials, etafilcon A lens was the most affected and nelfilcon A was the least affected by osmolality.·CONCLUSION: From the result obtained, it is revealed that Dk of contact lenses is changed by the p H,osmolality, and buffering condition of tear. Thus, Dk of contact lens can be varied by the lens wearers' physiological and/or pathological conditions.展开更多
AIM:To introduce a novel approach in removal of anterior chamber angle foreign body(ACFB) using a prism contact lens and 23-gauge foreign body forceps.METHODS:Data of 42 eyes of 42 patients who had undergone removal o...AIM:To introduce a novel approach in removal of anterior chamber angle foreign body(ACFB) using a prism contact lens and 23-gauge foreign body forceps.METHODS:Data of 42 eyes of 42 patients who had undergone removal of ACFB using a prism contact lens and 23-gauge foreign body forceps from January 2008 to October 2013 were collected and analyzed. Twenty eyes in group A received the conventional approach by using toothed forceps through corneal limbus incision, and 22 eyes in group B underwent the novel method through the opposite corneal limbus incision. RESULTS:The success rate of ACFB once removal was 75%(15/20) in group A, and 100%(22/22) in group B. The average operation time of group A was significantly longer compared with group B(34.9±9.88 min vs 22.13±8.85min; P<0.05). The average size of corneal limbus incision in group A was significantly larger than that of group B(4.85±1.89 mm vs 3.95±1.17 mm; P<0.05). The corneal limbus incision suturing were conducted in all eyes in group A, and only 5 eyes in group B. CONCLUSION:Removal of ACFB using a prism contact lens and 23-gauge foreign body forceps is a safer, more effective, and convenient technique compared with the conventional approach.展开更多
基金Supported by Science and Technology Projects of Guangdong Province (No.2013B021800178)Investigation on Health of Financial Staff in Guangzhou (No.Z012014075)
文摘AIM: To conduct a comparative study of effectiveness of silicone hydrogel contact lens and hydrogel contact lens, which are used in patients after laser-assisted subepithelial keratomileusis(LASEK).·METHODS: Sixty-three patients(121 eyes) with a spherical equivalent ≤-5.0 D were chosen after undergoing LASEK in 2012 at Guangdong General Hospital. They were randomly divided into 2 groups. The silicone hydrogel group included 32 cases(61 eyes) that wore silicone hydrogel contact lenses for 4-6d after the operation, while the hydrogel group included 31 cases(60 eyes) who wore hydrogel contact lenses for 4-6d after the operation. Patients’ self-reported postoperative symptoms(including pain, photophobia, tears, and foreign body sensation) were evaluated. The healing time of the corneal epithelium, the visual acuity of patients without contact lens after epithelial healing, and the incidence of delayed corneal epithelial shedding were also assessed. The follow-up time was 1mo.·RESULTS: Postoperative symptoms were milder in the silicone hydrogel group than in the hydrogel group.There were significant differences in pain, foreign body sensation, and photophobia between the 2 groups(P <0.05),although there was no significant difference in postoperative tearing(P >0.05). The healing time of the corneal epithelium in the silicone hydrogel lens group was markedly shorter than that in the hydrogel group(4.07±0.25 vs 4.33±0.82 d, t =2.43, P =0.02). Visual acuity without contact lenses after healing of the corneal epithelium was better in the silicone hydrogel group compared with the hydrogel group(χ~2=7.76, P =0.02).There was no significant difference in the occurrence ofdelayed corneal epithelial shedding between the 2 groups(P >0.05).· CONCLUSION: Patients with LASEK using silicon hydrogel contact lenses had less discomfort and shorter corneal epithelial healing time compared with those using hydrogel contact lenses, suggesting that silicon hydrogel contact lenses may be considered to be a better choice of bandage contact lens after LASEK.
基金Supported by the Beijing Municipal Science&Technology Commission,People’s Republic and Capital Clinical Characteristic Application Research Project(No.Z151100004015073)
文摘AIM: To evaluate the safety of therapeutic bandage contact lens for post-cataract surgery patients and to illustrate its efficacy on post-operative comfort and tear-film stability. METHODS: A total of 40 participants were recruited and randomly divided into two groups. Group one was instructed to wear bandage contact lenses for a week and use antibiotic eye drops for a month since the first day after surgery. Group two received sub-conjunctival injection of tobramycin and was asked to wear eye pads on the first day after surgery and then were instructed to use antibiotic eye drops as the first group did. Ocular surface disease index(OSDI) questionnaire, slit-lamp microscope examination of tear break-up time(TBUT), corneal fluorescein score(CFS), tear meniscus height(TMH) together with anterior segment optical coherence tomography(AS-OCT) and corneal topography were evaluated preoperatively and postoperatively. RESULTS: The subjective feeling(P=0.004), TBUT(P<0.001) and TMH(P=0.02) post-surgery had improved in patients who used bandage contact lenses compared with those who did not at 1wk post-surgery. Until three month postoperatively, the comfort degree(P=0.004) and TMH(P=0.01) of group two were still worse than group one. Moreover, TBUT(P<0.001) and CFS(P=0.004) of the group with eye pads got worse than the results before, whereas the group with bandage contact lenses recovered to normal. None of these patients had infections or other complications. CONCLUSION: Wearing therapeutic bandage contact lens after cataract surgery, compared with traditional eye-pads, is a safe method to improve tear-film stability and reduce post-operative discomfort without hindering corneal incision recovery.
文摘AIM: To evaluate the corneal cell morphology of new keratoconus patients wearing two different types of rigid gas-permeable(RGP) contact lenses for 1y.METHODS: Thirty nine eyes of 39 new keratoconus patients were selected and randomly fitted with two types of RGP contact lenses.Group 1 had 21 eyes with regular rigid gas-permeable(RRGP) contact lens and rest 18 eyes were in group 2 with specially designed rigid gas-permeable(SRGP) contact lens.Corneal cell morphology was evaluated using a slit scanning confocal microscope at no-lens wear and after 1y of contact lens wearing.RESULTS: After 1y of contact lens wearing in group 1,the mean anterior and posterior stromal keratocyte density were significantly less(P=0.006 and P=0.001,respectively) compared to no-lens wear.The mean cell area of anterior and posterior stromal keratocyte were also significantly different(P=0.005 and P=0.001) from no-lens wear.The anterior and posterior stromal haze increased by 18.74% and 23.81%,respectively after 1y of contact lens wearing.Whereas in group 2,statistically significant changes were observed only in cell density & area of anterior stroma(P=0.001 and P=0.001,respectively) after 1y.While,level of anterior and posterior stromal haze increased by 16.67% and 11.11% after 1y of contact lens wearing.Polymegathism and pleomorphism also increased after 1y of contact lens wearing in both the contact lens groups.CONCLUSION: Confocal microscopy observation shows the significant alterations in corneal cell morphology of keratoconic corneas wearing contact lenses especially in group 1.The type of contact lens must be carefully selected to minimize changes in corneal cell morphology.
文摘AIM: To determine the impact of rigid gas permeable(RGP) and silicone-hydrogel keratoconus lenses on the quality of life(Qo L) in keratoconus(KCN) patients using the self-reported results from the Contact Lens Impact on Quality of Life(CLIQ) Questionnaire.·METHODS: From January 2013 to April 2013, 27 consecutive KCN patients who wore RGP contact lenses(conflexair100 UV KE Zeiss-Whlk) or soft silicone-hydrogel contact lenses(SHCLs) for KCN(Kera Soft ICBausch&Lomb or Hydrocone Toris K-Swiss lens)completed the CLIQ questionnaire.·RESULTS: The mean age of 27 patients was 29.6±8.0y.Fifteen patients were RGP user. The groups were comparable with respect to the mean patient age, sex,and mean K values(P =0.1, P =0.8 and P =0.1, respectively).The mean CLIQperson measure was 42.8 ±5.5 in RGP group and 39.6 ±5.5 in SHCLs for KCN group(P =0.06).CLIQperson measure was positively correlated with steep K value(r =0.301, P =0.04). When eyes were stratified by visual acuity with contact lenses, the mean CLIQperson measure was 42. 01 ± 5. 6 in eyes with a visual acuity of20/20-20/25(n =44) and 38.4 ±5.26 in eyes with a visual acuity of 20/32 or less(n =10; P =0.097).·CONCLUSION: RGP lenses and SHCLs for KCN have similar impact on Qo L.
文摘AIM: To determine the effect of p H, osmolality, and buffering system on the oxygen permeability(Dk) of soft contact lenses.·METHODS: Two hydrogel lenses(nelfilcon A and etafilcon A) and 2 silicone hydrogel lenses(lotrafilcon A and balafilcon A) were used in the study. These lenses were incubated in phosphate-buffered saline(PBS) and borate-buffered saline(BBS) solutions adjusted by 0.8p H increments to a p H in the range of 5.8-9.0 or in hypotonic(280 m Osmol/kg), isotonic(310 m Osmol/kg)and hypertonic(380 m Osmol/kg) PBS solutions.Polarographic method was used for measuring the Dk and lenses were stacked as 4 layers to correct the boundary effect.·RESULTS: Dk values of all contact lenses measured in BBS solutions were more stable than those in PBS solutions. Especially the etafilcon A lens showed a relative big change compared with other types of contact lenses at the same conditions. When the osmolality of PBS solution increased from hypotonic to hypertonic, Dk of all contact lenses decreased. Variations in Dk existed depending on lens materials, etafilcon A lens was the most affected and nelfilcon A was the least affected by osmolality.·CONCLUSION: From the result obtained, it is revealed that Dk of contact lenses is changed by the p H,osmolality, and buffering condition of tear. Thus, Dk of contact lens can be varied by the lens wearers' physiological and/or pathological conditions.
文摘AIM:To introduce a novel approach in removal of anterior chamber angle foreign body(ACFB) using a prism contact lens and 23-gauge foreign body forceps.METHODS:Data of 42 eyes of 42 patients who had undergone removal of ACFB using a prism contact lens and 23-gauge foreign body forceps from January 2008 to October 2013 were collected and analyzed. Twenty eyes in group A received the conventional approach by using toothed forceps through corneal limbus incision, and 22 eyes in group B underwent the novel method through the opposite corneal limbus incision. RESULTS:The success rate of ACFB once removal was 75%(15/20) in group A, and 100%(22/22) in group B. The average operation time of group A was significantly longer compared with group B(34.9±9.88 min vs 22.13±8.85min; P<0.05). The average size of corneal limbus incision in group A was significantly larger than that of group B(4.85±1.89 mm vs 3.95±1.17 mm; P<0.05). The corneal limbus incision suturing were conducted in all eyes in group A, and only 5 eyes in group B. CONCLUSION:Removal of ACFB using a prism contact lens and 23-gauge foreign body forceps is a safer, more effective, and convenient technique compared with the conventional approach.
